Introduction

The purpose of the fund is to provide educational assistance to students who are members in good standing of the Mountain Heritage Federal Credit Union. NOTE: to be eligible for this scholarship, you must be a member of Mountain Heritage Federal Credit Union; to verify your membership please contact the Credit Union at 304-424-7256.

Recipients of this scholarship shall be selected on the basis of GPA, school activities, noteworthy achievements, special talents/circumstances, community and personal activities and awards and recognition.

Postmark Deadline for Submission – March 1

Student Name: ______
Date of Birth: ______
Address: ______
Phone: ______
Are you a member of the Mountain Heritage Federal Credit Union? ____ Yes ____ No

Educational Information

High School Name:______

High School Address: ______

High School Graduation Date (or anticipated graduation date): ______

Standardized Test Scores (if not listed on high school transcript):

Type of Test: ______Date of Test: ______Score: ______

Post-Secondary School Name: ______

Post-Secondary School Address: ______

This school is a (check one):

____ 4-year college/university

____ 2-year college/university

____ vocational/technical school

____ Other: ______

Upcoming year in post-secondary school:

____ 1 ____ 2 ____ 3 ____ 4 ____ 5 ____ Masters ____ PhD

Do you plan to attend post-secondary school full-time? ____ Yes ____ No

Degree Anticipated:

____ Bachelor of Arts

____ Bachelor of Science

____ Other

Major/Field of Study: ______

Anticipated Graduation Date: ______

Activities

List activities in which you have been involved, including high school, post-secondary school, and community activities (attach additional sheet if necessary)

Activity / Dates of Participation / Special Honors/Offices

Employment History

Position Held / Period of Employment / Hours per Week
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to
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Personal Statement

Attach on a separate sheet a Personal Statement of 300 words or less, describing your current academic standing, activities, and achievements.

Attachments Checklist

Attach one copy of each:

  • Up to three letters of reference attesting to your community and personal activities.
  • High school transcript.
  • If applicable, post-secondary school transcript.

Certification

I certify that all information on this form is true and complete to the best of my knowledge. I understand that I may be asked to provide proof of information stated on this form.

Signature of Applicant: ______Date: ______

Submit Application

One copy of the application and one copy of attachments must be postmarked no later than March 1 and sent to:

June Keeper Scholarship Fund c/o PACF, PO Box 1762, Parkersburg, WV 26102-1762

Questions about Scholarships at the PACF

For additional question regarding the Foundation’s Scholarships Programs please contact:

Rachel Brezler

Regional Scholarships Officer

______

Parkersburg Area Community Foundation & Regional Affiliates

PO Box 1762 | 1620 Park Ave. | Parkersburg, WV 26102-1762

p: 304.428.4438 | f: 304.606.3030

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June Keeper Scholarship Fund Application